Rule on Detaining Homeless Patients Passes Panel Test

SACRAMENTO — Legislation aimed at keeping homeless people who are mentally ill off the streets by holding them longer against their will in county mental hospitals won bipartisan support Tuesday and cleared its first Assembly committee test.

The bill, authored by Assemblywoman Doris Allen (R-Cypress) and sponsored by Los Angeles County, would allow county mental hospitals to hold patients involuntarily for an extra 30 days without the provisions of a court-approved conservatorship.

The measure, which is supported by a broad range of law enforcement and mental health officials as well as mental health advisory groups, was approved by the Assembly Health Committee 13-1 and sent to the Ways and Means Committee.

Opposition Voiced

Opponents, including the American Civil Liberties Union and patients’ rights representatives, argued that the state’s scarce mental health funds should be directed at helping people stay out of mental hospitals, not keeping them in.

But pleas from county officials and parents of mentally ill patients appeared to sway the panel’s subcommittee on mental health, which considered the measure during a two-hour hearing before recommending that the full committee approve it.

Although the legislation would apply to all those with psychiatric illnesses, the bill is aimed at the homeless mentally ill, who, according to Los Angeles County Supervisor Mike Antonovich, account for as much as 35% of the county’s homeless population.

Current law allows county mental hospitals to hold patients for 72 hours without a hearing if a psychiatrist judges them to be a danger to themselves or others or gravely disabled by mental illness or chronic alcoholism. Patients may be held an additional 14 days provided the psychiatrist’s findings are certified at an administrative hearing, which involves little paperwork and is often held at the hospital.

Suicidal patients may be held another 14 days, and those judged to be “imminently dangerous” may be detained for another 180 days.

Patients who are not suicidal or imminently dangerous can be held longer than 17 days against their will only if the county obtains a Superior Court order for a temporary conservatorship. This process involves an investigation by the public guardian’s office, which determines whether the patients should be deprived of their freedom and have a guardian appointed for them.

Picked Up Repeatedly

Proponents of the bill argued that the 17 days patients can be held without a court hearing are not sufficient. They said many patients, particularly the mentally ill homeless, are picked up for emergency treatment time and again because they are not hospitalized long enough to receive proper treatment.

Allen’s bill would allow hospitals to detain patients for a total of 47 days without a court hearing. It also would allow mental health officials to place patients against their will in out-patient facilities for part of that time.

“We are holding gravely disabled people for a short time and then releasing them back on the streets,” Allen said.

Roberto Quiroz, director of the Los Angeles County Mental Health Department, said the county has implemented new programs to help the homeless mentally ill but cannot do much more without the authority to hold patients for a longer time without a court hearing.

“This legislation does not take away the rights of individuals,” Quiroz said. “It allows the individual to receive adequate care until such time that we in the community can provide the necessary services that are important for them to recover fully.”

Long-Run Concerns

Opponents argued that the bill would encourage more involuntary hospitalizations and medication of patients but would do little in the long run to cut down on the number of mentally ill homeless. They said dangerous patients can be held under current law if mental health providers are willing to obtain an administrative certification or a court order.

“We need to be looking at the quality of service provided instead of looking at ways to force people into services that have not been effective,” said Jean Matulis, a former mental patient who is now a patients’ rights advocate.

ACLU Lobbyist Marjorie Swartz said the state’s resources would be better spent on counseling programs to follow up on patients after they are released from the hospital.